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From the 9/3/2021 release of VAERS data:

This is VAERS ID 1431381



Case Details

VAERS ID: 1431381 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-01-30
Onset:2021-06-26
   Days after vaccination:147
Submitted: 0000-00-00
Entered: 2021-06-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, SARS-CoV-2 test positive
SMQs:, Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Eliquis, Atorvastatin, Doxazosin, Losartan, Pantoprazole, Dexamethasone, Lantus, Cholecalciferol.
Current Illness: Ascending aortic aneurysm w/endovascular stent graft, hyperlipidemia, OSA, PVD, DM2, TIA, GERD, CAD w/stents and CABG, CKD Stage 4, COPD, h/o PE, BPH and L-renal stenosis.
Preexisting Conditions: Ascending aortic aneurysm w/endovascular stent graft, hyperlipidemia, OSA, PVD, DM2, TIA, GERD, CAD w/stents and CABG, CKD Stage 4, COPD, h/o PE, BPH and L-renal stenosis.
Allergies: NKDA
Diagnostic Lab Data:
CDC Split Type:

Write-up: COVID (+) 6/26/21 -- $g admitted to Medical Center despite being fully vaccinated.


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1431381


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